Anxiety and Panic Attacks
As W.H. Auden pointed out, we live in the age of anxiety. Most of us suffer from a certain level of chronic anxiety because modern life is jagged, fast-paced, and divorced from the natural rhythms that tend to create a harmonious inner life. For some, this existential unease goes further and becomes a psychological disorder.
Typical symptoms of anxiety disorder include feelings of tension, irritability, worry, frustration, turmoil, and hopelessness, along with insomnia, restless sleep, grinding of teeth, jaw pain, an inability to sit still, and an incapacity to cope. Physical sensations frequently arise as well, including a characteristic feeling of being unable to take a full, satisfying breath; dry mouth; rapid heartbeat; heart palpitations; a lump in the throat; tightness in the chest; and cramping in the bowels. Anxiety can also give rise to panic attacks. These may be so severe that they are mistaken for heart attacks. The heart pounds and palpitates, the chest feels tight and painful, and the whole body tenses with unreasonable fear. Such attacks can be triggered by anxiety-provoking situations, but they may also come out of nowhere, perhaps even awakening you from sleep. When a person tends to suffer more from panic attacks than generalized anxiety, physicians call the illness panic disorder.
The medical treatment of anxiety involves anti-anxiety drugs in the benzodiazepine family, the unique drug BuSpar (buspirone), and antidepressants. Panic attacks are generally more difficult to treat than other forms of anxiety.
Proposed Natural Treatments
There are no natural treatments for anxiety that have been shown to be safe and effective. However, some treatments have shown promise for generalized anxiety disorder and related conditions. No natural treatment is likely to be effective for panic disorder.
Valerian: May Provide Calming Effects
The herb valerian is best known as a remedy for insomnia. However, because many drugs useful for insomnia also reduce anxiety, valerian has been proposed as an anxiety treatment as well.
In a double-blind, placebo-controlled study, 36 people with generalized anxiety disorder were given either valerian extract, valium, or placebo for a period of 4 weeks. 8 The study failed to find statistically significant differences between the groups, presumably due to its small size. However, a careful analysis of the results hints, at least, that valerian was helpful.
In addition, a preliminary double-blind study found that valerian may produce calming effects in stressful situations.
For more information, including dosage and safety issues, see the full
Up until 2002, the herb kava was widely used in Europe as a medical treatment for anxiety, based on the evidence of a substantial body of double-blind, placebo-controlled studies. However, because of recent concerns involving its potential effects on the liver, it has been withdrawn from the market in many countries, and we do not recommend its use. For more information, see the full
Other Herbs and Supplements
A large (264-participant) 3-month, double-blind, placebo-controlled study tested the possible anti-anxiety benefits of a combination therapy containing the mineral
A double-blind, placebo-controlled trial of 80 healthy male volunteers found that 28 days of treatment with a
Based on its apparent ability to promote sleep,
A 4-week, double-blind study of 36 individuals with anxiety (specifically, generalized anxiety disorder) compared the herb
Several small double-blind studies by a single research group have found preliminary evidence that oral use of
A double-blind, placebo-controlled trial of 40 individuals found that
is traditionally used as a “nerve tonic” by Mexican herbalists. One substantial double-blind study purportedly found that a standardized Galphimia extract is as effective as the standard medication lorazepam.
Other herbs or supplements that are frequently recommended for anxiety attacks include
Various alternative therapies have shown some promise for the treatment of anxiety, including
There is a fair amount of evidence in support of
Various herbs and supplements may interact adversely with drugs used to treat anxiety. For more information on this potential risk, see the individual drug article in the Drug Interactions section of this database.
3. Bruggemann VF, Meyer HJ. Studies on the analgesic efficacy of the kava constituents dihydrokavain (DHK) and dihydromethysticin (DHM) [in German; English abstract]. Arzneimittelforschung. 1963;13:407-409.
12. Malsch U, Klement S. Randomized placebo-controlled double-blind clinical trial of a special extract of kava roots (WS 1490) in patients with anxiety disorders of non-psychotic origin [abstract]. Eur Phytojournal [serial online]. 2000. The European Scientific Cooperative on Phytotherapy website. Available at: http://www.escop.com/issue_1 . Accessed May 10, 2001.
28. Kohnen R, Oswald WD. The effects of valerian, propranolol, and their combination on activation, performance and mood of healthy volunteers under social stress conditions. Pharmacopsychiatry. 1988;21:447-448.
29. Eich H, Agelink MW, Lehmann E, et al. Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study [in German; English abstract]. Fortschr Neurol Psychiatr. 2000;68:137-144.
30. Carroll D, Ring C, Suter M, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl). 2000;150:220-225.
31. Kahn RS, Westenberg HG, Verhoeven WM, et al. Effect of a serotonin precursor and uptake inhibitor in anxiety disorders; a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo. Int Clin Psychopharmacol. 1987;2:33-45.
33. Naguib M, Samarkandi AH. The comparative dose-response effects of melatonin and midazolam for premedication of adult patients: a double-blinded, placebo-controlled study. Anesth Analg. 2000;91:473-479.
34. Bradwejn J, Zhou Y, Koszycki D, et al. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. J Clin Psychopharmacol. 2000;20:680-684.
35. Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001;26:363-367.
44. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts ( Crataegus oxyacantha and Eschscholtzia californica ) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin. 2004;20:63-71.
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Last reviewed April 2009 by EBSCO CAM Review Board
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